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Conundrums in Managing Early Stages of Schizophrenia

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Complex Clinical Conundrums in Psychiatry

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Abstract

Schizophrenia continues to be one of the most consuming mental illnesses, in terms of both the personal disability caused and the economic burden imposed on an individual and the society. While the provision of early intervention services has greatly enhanced the pathways of care provided, several challenges remain in clinical assessment and management during the early stages that pose critical questions for a clinician. Informed decision-making at these junctures is crucial to favorably alter the course of long-term outcomes. The following chapter will review clinical features of the early stages of schizophrenia, along with a discussion of evidence-based treatment approaches. Additionally, we highlight the role of a primary care physician in managing early stages of psychosis. Given the criticality of early intervention for long-term outcome, we discuss the malleable clinical factors that influence the trajectory of schizophrenia using a case example.

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Disclosure Statement

Alkomiet Hasan has received paid speakership by Desitin, Otsuka and Janssen Cilag. He was a member of the Roche, Lundbeck and Janssen-Cilag Advisory Board. Lena Palaniyappan has received paid speakership by Otsuka / Lundbeck. Other authors declare no conflicts.

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Authors and Affiliations

  1. PEPP Program, London Health Sciences Centre, Robarts Research Institute and Department of Psychiatry, University of Western Ontario, London, ON, Canada

    Lena Palaniyappan MBBS, FRCPC, PhD & Ross Norman PhD

  2. Urgent Care and Ambulatory Mental Health, London Health Sciences Centre and University of Western Ontario, London, ON, Canada

    Priyadharshini Sabesan MBBS, MRCPsych

  3. Department of Psychiatry and Psychotherapy, Klinikum der Universität München, Ludwig-Maximilians Universität München, Munich, Germany

    Alkomiet Hasan MD

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  1. Lena Palaniyappan MBBS, FRCPC, PhD
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  2. Priyadharshini Sabesan MBBS, MRCPsych
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  3. Ross Norman PhD
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  4. Alkomiet Hasan MD
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Correspondence to Lena Palaniyappan MBBS, FRCPC, PhD .

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Editors and Affiliations

  1. Department of Psychiatry, Northern Ontario School of Medicine Psychiatry Department, Sudbury, Ontario, Canada

    Kuppuswami Shivakumar

  2. Woodstock General Hospital, Woodstock Ontario, University of Western Ontario, London, Ontario, Canada

    Shabbir Amanullah

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Palaniyappan, L., Sabesan, P., Norman, R., Hasan, A. (2018). Conundrums in Managing Early Stages of Schizophrenia. In: Shivakumar, K., Amanullah, S. (eds) Complex Clinical Conundrums in Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-319-70311-4_10

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